Needlescopic Cholecystectomy Versus Needlescope-assisted Laparoscopic Cholecystectomy

Abstract

This clinical study was performed to compare the feasibility, safety, and best use of the needlescope and needlescopic instruments. Needlescopic cholecystectomy (NC) or needlescope-assisted cholecystectomy (NAC) was performed in 40 cases of gallbladder (GB) stone or polyp. There were 12 men and 28 women, with a mean age of 51.8 years (range, 27 to 79 y). The port sites consisted of three 2-mm ports at the right upper quadrant and one 12-mm port at the umbilicus. To evaluate the feasibility and safety of the needlescope, the time taken to perform each operative step was compared for NC and NAC. Operation time was divided into: (1) skin incision to insertion of the 4 ports; (2) insertion of the 4 ports to cannulation into the cystic duct; (3) time of intraoperative cholangiography (IOC); (4) skin incision to cutting of the cystic duct without IOC; (5) cutting the cystic duct to dissection of the GB; (6) dissection of the GB to removal of the GB; (7) removal of the GB to skin closure; and (8) total operation time. IOC was performed successfully in 10 cases of NC and 10 cases of NAC. Respective mean times of the 8 steps were 5.4 versus 5.3 minutes, 34.2 versus 32.2 minutes, 20.1 versus 18.4 minutes, 33.9 versus 31.3 minutes, 19.6 versus 18.9 minutes, 3.1 versus 2.9 minutes, 10.0 versus 10.2 minutes and 82.5 versus 77.8 minutes for NC versus NAC, respectively. There were no significant differences in any of the factors related to surgical procedures between the 2 groups, and there were no perioperative complications. The use of a needlescope and needlescopic instruments was feasible and safe for laparoscopic cholecystectomy in both surgical laparoscopic procedures for highly selected patients.